AUTHOR: Dr. Jason Bush

Celiac Disease involves a complex autoimmune reaction initiated by the consumption of gluten-containing foods that causes the breakdown of the walls of the small intestine.  Fortunately, people with Celiac Disease or gluten intolerance generally find symptom relief by following a gluten-free diet.  Adhering to a gluten-free diet is challenging because of the seemingly ubiquitous nature of wheat products but it presents an effective drug-free strategy for dealing with this health problem.  However, following a gluten-free diet may introduce new, unanticipated health challenges.

Whole wheat products are inherently rich in fiber – both non-fermentable forms, such as cellulose, and fermentable prebiotics, such as inulin.  Even white flour contains fiber, mostly arabinoxylan oligosaccharides, which make up about 2% of the flour by weight.  Wheat bran is a good source of prebiotic inulin and it is estimated that most North Americans get most their 1-4 g daily intake from wheat products.  Western Europeans obtain between 22 – 37% of their fiber intake from cereal products, which often contain wheat.  For these reasons, people following a gluten-free diet may be inadvertently cutting out a significant portion of their daily prebiotic intake.

It is important for individuals adopting restrictive diets to make efforts to obtain certain nutrients from alternative sources.  In the case of a vegan, who may obtain insufficient amounts of vitamin B12 from their meat- and dairy-free diet, it may be necessary to consume foods supplemented with vitamin B12 or consider a vitamin supplement.

Since cutting wheat products from the diet significantly reduces the intake of prebiotics, individuals on a gluten-free diet may want to increase their consumption of other foods containing prebiotics.  Most replacement flours used in gluten-free baking, including tapioca and rice flour, are very low in fiber and prebiotics after being cooked, so increasing the amount of fiber-rich legumes, vegetables, and fruits in the diet is advisable.  In many cases, adding a prebiotic supplement may also be necessary.

A gluten-free diet should be a solution to digestive issues, not a duct-tape fix that addresses some issues while introducing others.  Adequate dietary fiber is important for normal digestive function, including the prevention of constipation.  And prebiotics provide many important health benefits by providing food for healthy bacteria (aka. Probiotics) living in the gut.  Supplementing a gluten-free diet with appropriate prebiotic fiber will let individuals with gluten sensitivities avoid trigger foods while ensuring that they consume a healthy, balanced diet.



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